A Pain in the Nose

For as long as I can remember, headaches have been a part of my life. I don’t know how old I was when I got my first headache, but I distinctly remember crushing, nausea-inducing sinus pain in middle school. My pediatrician at the time referred me to a headache specialist – a serious, middle-aged man with silver hair and thick glasses – who asked me in my first appointment to describe the pain. I pointed to the base of my nose, my forehead and the back of my neck. “Pretty much everywhere,” I said.

The doctor recommended an MRI to see if he could find the source of my headaches, and also to see why I couldn’t smell. Perhaps, he said, they were related. I had never heard of an MRI before but it was an excuse to miss school, so I was cool with it.

The MRI came back inconclusive, which was good and bad. Good in that there were no red flags, but bad because it failed to pinpoint why I was in pain. The doctor suggested I would probably grow out of my headaches, but in the meantime I should take pain relievers whenever I felt a headache coming on. At the time, I wasn’t taking anything for my headaches outside of liquid Tylenol on occasion. He wanted me to take pain relievers in pill form, which posed a problem: I couldn’t take pills.

Mind you, I was 13, so I wasn’t quite a big boy just yet. Let’s just say that I was mortally afraid of choking on pills. I was still taking Fred Flintstone chewable vitamins, after all. (Full disclosure: they tasted – and still taste – really good. Not that I still take them, but you know what I mean.) When I told him this, he furrowed his brow. There was something liquid I could take, he told me, and wrote out a prescription. Naproxen.

The first time I opened the orange bottle and poured out the liquid onto my spoon, my stomach turned. It was oily and orange. Deep down I hoped it would taste like orange juice, because it looked like thick orange juice. I couldn’t smell, so I had no way of knowing. I put the spoon in my mouth and drank the liquid and….good Lord. I gagged and almost threw up in the sink. By far the most disgusting thing I’ve ever tasted.

The headaches weren’t every day, but frequent enough to worry me. Yet, I worried even more about taking the naproxen, convinced that the next time I took it I would actually throw up. With newfound courage and motivation, I conquered my fear of pills and within a few months had transitioned to Excedrin Extra Strength.

18 years later, I was still taking Excedrin. The fine print on the bottle says to take it on occasion. By 2018, I was taking it every other day. Rebound headaches for sure, but I was caught in the vortex. To try and wean myself off of Excedrin meant vicious migraines. Sure, it sounds straightforward. But trust me, it’s the kind of pain that breaks your resolve in a hurry.

I tried removing certain foods from my diet. I tried stretching, vitamin supplements, quitting caffeine. I even went to a chiropractor who I’m pretty sure broke my neck during the appointment. The headaches always won. Nothing worked. I was discouraged. I grudgingly accepted that it would never change.

And then, they were gone.

Last year, because we had moved down to the Connecticut shoreline, I had to get a new primary care doctor. At my physical, I told him about my headaches, and he suggested I might have a deviated septum. I frowned, then suddenly it made sense. I breathed into my nose and felt congestion in my right nostril. He suggested it was likely because my septum was blocking airflow up through my sinuses, causing the pressure to accumulate and thus the sinus headaches. He suggested an ear, nose and throat (ENT) doctor. Intrigued, I booked an appointment as soon as I got home.

I was pessimistic anything would come of it, but I held out a little bit of hope. At the same time, I was upset. I had seen another headache doctor in 2017, who at no point suggested that my sinus headaches could be caused by a deviated septum. I was almost prescribed antidepressants to combat the headaches, a treatment I felt was a bridge too far.

In early September, I went to an ENT doctor, Dr. Astrachan, based out of Madison. He took a look in my nostrils and suggested I get a CT scan of my nasal passages. He agreed with my primary care doctor that a deviated septum was likely the cause.”I see this all the time,” he said matter-of-factly.

“And what happens then?” I asked sheepishly, knowing the answer.

“Surgery,” he said. “We’ll correct it. 50-50 chance it’ll help with the headaches, but at minimum, you’ll breathe a lot better and have less sinus pressure.”

50-50. Those are good odds, I thought.

The CT scan indicated that my septum was deviated. Really, really deviated, almost comically so. The course of action was clear: surgery. Although I was a little apprehensive about having surgery on my nose (my parents joked I was having a nose job), I knew that the reward could be worth it. It had the potential to be life-changing. I scheduled the surgery for December 13th, a month and a half away.

My biggest fear about the surgery wasn’t the pain, or the recovery period where I’d have gauze stuck in my nose. It was giving up Excedrin two weeks before surgery. Since it contained aspirin, if I continued to take it up until surgery time, I’d run the risk of excessive bleeding during the surgery. The prospect of agonizing withdrawal headaches sent a chill down my spine. How would I get through two weeks with extreme headaches?

I kept reminding myself to take the long view. For my own well-being, I needed to find a way to minimize these headaches, which were taking a toll on my quality of life and probably taking a toll on my liver and kidneys as well.

Before I knew it, it was November 30th, the two-week period where I had to give up Excedrin. The first day, almost on cue, a terrible headache. I drank coffee and took Tylenol, two of the three ingredients in Excedrin, but no relief. I agonized in bed with a cloth on my head. I was a pathetic sight. But eventually, in a cold sweat, it passed. Over the next two weeks I had several more headaches, but none matched the level of the first one. But even then, the pain was intense.

Finally, the day of my surgery came. Going in, I replayed the odds in my mind. 50-50? Will it really help? I wanted to believe it, but was skeptical. Maybe it was a self-defense mechanism. Set the bar low so I won’t be disappointed if it doesn’t pan out.

The surgery was uneventful. They administered the anesthesia, I counted backwards from 10….and before I knew it, I was awake again. My nose was in pain, as if I had smashed it on a freezer door. I was also dizzy and loopy. I touched the bandage on my nose, even though they explicitly told me not to. Ouch! Not a good idea. I tried to wiggle my nostrils but they were jammed up with gauze. Underneath my nostrils was a bandage, with rubber band straps around my ears. After an hour I left the hospital, desperate to go home and rest.

Sleeping was a struggle. I slept at an almost 90-degree angle, and took Vicodin every few hours. The next day, sleep-deprived, Dr. Astrachan pulled the bandage out of my nose. It felt like he was pulling out my brain, but after a few seconds of intense pain, I could breathe again, although my nose was sore. Worse, I was told I couldn’t sneeze or blow my nose for a week. I groaned, but knew that I had to trust the pain. It would be worth it in the end.

The recovery was brutal. I was sick all weekend with what felt like the flu. I was achy. I was sore. My head pounded. I took more Vicodin, which helped temporarily, but it didn’t last long and the pain came roaring back. All through the weekend I feared that it wasn’t going to get better, that after all this pain went away, the headaches would remain.

Monday, I returned to work but still wasn’t feeling 100%. My nose was still stuffy and in pain, but I felt significantly better than I felt over the weekend. But it was still too early to tell if the surgery was successful.

The next three days were a progressive improvement. I had sinus pressure still, since I couldn’t blow my nose, but I was able to survive without feeling the need to take headache medicine. On Thursday, a week post-surgery, I went to see Dr. Astrachan to have my snots removed. (Sorry, but that’s what happened.)

“Take a deep breath,” he said, after doing what he needed to do.

I breathed in and although it tingled, I was able to breathe completely. I took another breath. Whoa. Any residual sinus pressure from my stuffy nose dissipated. I can breathe!

But would the headaches return? That was the million-dollar question that only time would reveal.

Well, I am three weeks now post-surgery, and I haven’t had a headache. The last time I took Excedrin was a month ago today, December 3rd. I still feel sinus pressure on occasion, but nothing compared to what it was before the surgery.

This has been a game-changer. In time, potentially a life-changer. An answer to many years of prayers.